Department of Internal Medicine and Gerontology, Jagielonian University Medical Colege, Sniadeckich 10, PL 31-531 Kraków, Poland.
Pharmacol Rep. 2013;65(4):891-7. doi: 10.1016/s1734-1140(13)71070-3.
Asymmetric dimethylarginine (ADMA) is associated with endothelial injury. Increased ADMA levels are found in rheumatoid arthritis (RA) and ankylosing spondylitis (AS). We set out to assess the ADMA and symmetric dimethylarginine (SDMA) levels in AS, RA, and healthy controls, and in the anti-TNF treated patients with active AS.
In 78AS patients and 29 RA patients who were anti-TNF treatment naive at baseline, along with 23 healthy control subjects, we assessed erythrocyte sedimentation rate (ESR), high-sensitivity C-reactive protein (hsCRP), ADMA, and SDMA. For AS patients, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), back pain VAS and patient's global activity of disease were calculated. After 6 months, we repeated the assessment in 30 out of the 78 AS patients in whom the anti-TNF treatment was initiated.
The baseline mean (SD) plasma ADMA concentration of AS patients was 0.64 (0.19) μmol/l and did not differ from controls (0.65 [0.19] μmol/l, p > 0.05). In the RA group, ADMA concentration was higher than in controls (0.77 vs. 0.65 μmol/l, p < 0.05). Both at baseline and at follow-up, ADMA levels correlated positively with BASDAI (R = 0.52, p = 0.02, and R = 0.47, p = 0.04, baseline and follow-up, respectively). Six months of anti-TNF treatment did not influence ADMA concentration (0.51 [0.12] vs. 0.51 [0.11] μmol/l, p = 0.70).
An absence of changes in plasma ADMA levels in the anti-TNF treated AS group despite the improvement in disease activity (BASDAI) and inflammation (ESR, CRP) may suggest either a lack of effect, or, even if such an effect were to take place, it needs not imply measurable changes in blood ADMA.
不对称二甲基精氨酸（ADMA）与内皮损伤有关。类风湿关节炎（RA）和强直性脊柱炎（AS）患者的 ADMA 水平升高。我们旨在评估 AS、RA 和健康对照组以及接受 TNF 拮抗剂治疗的活动期 AS 患者的 ADMA 和对称性二甲基精氨酸（SDMA）水平。
在 78 例 AS 患者和 29 例 RA 患者（基线时未接受 TNF 拮抗剂治疗）以及 23 例健康对照者中，我们评估了红细胞沉降率（ESR）、高敏 C 反应蛋白（hsCRP）、ADMA 和 SDMA。对于 AS 患者，计算了 Bath 强直性脊柱炎疾病活动指数（BASDAI）、腰背疼痛 VAS 和患者整体疾病活动度。6 个月后，我们对其中 30 例开始接受 TNF 拮抗剂治疗的 AS 患者重复了评估。
AS 患者的基线平均（SD）血浆 ADMA 浓度为 0.64（0.19）μmol/L，与对照组无差异（0.65 [0.19] μmol/L，p>0.05）。在 RA 组中，ADMA 浓度高于对照组（0.77 比 0.65 μmol/L，p<0.05）。无论是在基线还是随访时，ADMA 水平与 BASDAI 均呈正相关（R=0.52，p=0.02 和 R=0.47，p=0.04，分别为基线和随访时）。6 个月的 TNF 拮抗剂治疗并未影响 ADMA 浓度（0.51 [0.12] 比 0.51 [0.11] μmol/L，p=0.70）。
尽管 TNF 拮抗剂治疗后疾病活动度（BASDAI）和炎症（ESR、CRP）改善，但 AS 患者的血浆 ADMA 水平未发生变化，这可能表明无影响，或者即使存在这种影响，也无需在血液 ADMA 中检测到可测量的变化。
